<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">

        <div class="layui-row">
            <div class="layui-col-xs6">
                <div class="layui-form-item">
                    <label class="layui-form-label">姓名</label>
                    <div class="layui-input-block">
                        <input type="text" name="name" class="layui-input" lay-verify="required" placeholder="请输入姓名" value="{$row.name|default=''}">
                    </div>
                </div>
                <div class="layui-form-item">
                    <label class="layui-form-label">手机号</label>
                    <div class="layui-input-block">
                        <input type="text" name="mobile" class="layui-input" lay-verify="required|phone" placeholder="请输入手机号" value="{$row.mobile|default=''}">
                    </div>
                </div>
                <div class="layui-form-item">
                    <label class="layui-form-label">密接等级</label>
                    <div class="layui-input-block">
                        <select name="level">
                            <option value=''></option>
                            {foreach $getLevelList as $k=>$v}
                            <option value='{$k}' {in name="k" value="$row.level"}selected=""{/in}>{$v}</option>
                            {/foreach}
                        </select>
                    </div>
                </div>
            </div>
            <div class="layui-col-xs6">
                <div class="layui-form-item">
                    <label class="layui-form-label">性别</label>
                    <div class="layui-input-block">
                        {foreach $getSexList as $k=>$v}
                        <input type="radio" name="sex" value="{$k}" title="{$v}" {in name="k" value="$row.sex"}checked=""{/in}>
                        {/foreach}
                    </div>
                </div>
                <div class="layui-form-item">
                    <label class="layui-form-label">身份证号</label>
                    <div class="layui-input-block">
                        <input type="text" name="id_card" class="layui-input" lay-verify="required|identity" placeholder="请输入身份证号" value="{$row.id_card|default=''}">
                    </div>
                </div>
                <div class="layui-form-item">
                    <label class="layui-form-label">工作单位</label>
                    <div class="layui-input-block">
                        <input type="text" name="employer" class="layui-input" lay-verify="required" placeholder="请输入工作单位" value="{$row.employer|default=''}">
                    </div>
                </div>
            </div>
        </div>
        {if $isSuper}
        <div class="layui-form-item">
            <label class="layui-form-label">居住地所属社区</label>
            <div class="layui-input-block">
                <select name="community">
                    {foreach $getCommunityList as $k=>$v}
                    <option value="{$v.id}" {in name="v.id" value="$row.community"} selected{/in}>{$v.name}</option>
                    {/foreach}
                </select>
            </div>
        </div>
        {/if}
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label">现居住地址</label>
            <div class="layui-input-block">
                <textarea name="living" class="layui-textarea" lay-verify="required" placeholder="请输入现居住地址">{$row.living|raw|default=''}</textarea>
            </div>
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label">户籍所在地</label>
            <div class="layui-input-block">
                <textarea name="domicile" class="layui-textarea" lay-verify="required" placeholder="请输入户籍所在地">{$row.domicile|raw|default=''}</textarea>
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>

    </form>
</div>